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Emerging markets may shame developed markets into action on the m-health front

Informa Telecoms & Media hosted the inaugural Mobile Healthcare Industry Summit in London in early December, with speakers from major vendors, such as Intel, Qualcomm, Microsoft and RIM, and major telecoms operators, such as BT, France Telecom and Vodafone. It was a First World setting with predominantly First World protagonists and participants and a lot of First World technology on show. But it is the Third World – or emerging markets, to use a more current term – that might actually end up playing the leading role in mobile healthcare.

Although there are plenty of apparently robust mobile-health “solutions” out there, and there’s a compelling business case for their use as an extension of digitization efforts by health authorities, most are still in the pilot phase of deployment, awaiting widespread take-up. One big barrier is budgetary constraints. But, more significantly, there is a lot of resistance to change within the institutions and among the professionals working in healthcare. The healthcare industry is one of the last big industries to be touched by automation, and it can be very conservative and set in its ways.

Some of the resistance is based on risk aversion – the fear of what harm these new technologies might do to, for example, patient-data privacy or patient health itself. But there is also resistance based on vested interests – on the fear that the technology might make redundant certain tasks or jobs performed by humans – even though health services are overstretched already and demand for them is rising so steeply that any efficiencies these technologies bring are unlikely to lead to job losses.

People are naturally resistant to change, no matter where they live. But, in the case of healthcare, that resistance is harder to fight in countries where there is a well established health industry. In emerging markets, where many areas lack even the most basic healthcare infrastructure, a large void is waiting to be filled – with no legacy institutions or professions obstinately clinging to old ways. In these countries, operators can actually spearhead the provision of frontline health services – in the same way that they are doing with banking and digital-money services, of which there is also a severe dearth in many parts of the developing world.

A telling statistic revealed by Vittorio Colao, CEO of Vodafone Group and keynote speaker at the event, is that although there are 2.3 billion mobile subscriptions in the developing world, there are only 11 million hospital beds and 300 million computers.

Different needs

Although in the developed world the priorities that m-health services should address are the chronic-illness and lifestyle-choice issues facing an increasingly aging population, in the developing world the priorities are the provision of basic healthcare – to stop children from dying from hunger and infectious diseases and to deal with injuries and other emergencies.

M-health projects are under way in numerous developing countries to, for example, deliver health information to frontline staff in outlying areas; to collect information out in the field on infectious diseases and other illnesses and send it back remotely to health centers; and to train healthcare workers. Many of these projects are happening in Africa, involving operators such as Vodafone and welfare organizations such as the UN.

It is still early. Most of these projects have not achieved significant scale. But given enough funding, things are likely to move faster in emerging markets than in developed ones. Many of the vendors that have been hitting brick walls in some of the richest parts of the world might ironically find a more fertile ground for their products in some of the poorest. And the products that take root there might eventually make their way back to the rich world, where governments, health authorities and health professionals might finally be shamed into action.

One comment

Politics and vested interests aside there are fundamental flaws in the business cases for m-health solutions aimed at managing chronic illnesses, resolving poor life style choices or assisting aging populations. The cost of devices required for monitoring is high. The care pathways required to ensure consistent assessment of needs followed by selection of the correct equipment are not there. The knowledge required by patients and their families to ensure that equipment is used correctly and looked after appropriately has not been fully developed or disseminated to where it is needed. It is partly in this context that there is resistance from the healthcare profession. Ultimately these same issues will affect uptake in emerging countries once the need moves from provision of basic healthcare to managing more serious issues.

The emerging markets have much to do before that can begin to shame developed markets into action. Developed markets need to look at their own value chains and procedures for adopting new technology and forcing change.

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